State bill to allow medical aid in dying moves forward

The right to die in Hawaii

Joe Herzog, who has stage four prostate cancer, tells his story to lawmakers on Wednesday in Honolulu. Herzog is supporting a bill to allow adults who have a terminal illness to get a prescription for medication to end their lives. The Hawaii Senate Committee on Commerce, Consumer Protection and Health unanimously passed the bill Wednesday. AP photo

The Associated Press

HONOLULU — As a stage-four prostate cancer patient, Joe Herzog has been considering how he might die and knows he could face intractable vomiting and starvation in the final days or weeks of his life.

As a retired veterinarian, Herzog said he believes he should have the same right that pet owners have to enable their feline and canine companions to die peacefully at home with medication.

Herzog, 57, was one of dozens of people to testify Wednesday at a hearing on a bill that would allow adult Hawaii residents who have a terminal illness to get a prescription for medication to end their lives.

“I’ve had a good life. I don’t want to have a nasty death,” Herzog said.

The Senate Committee on Commerce, Consumer Protection and Health unanimously passed the bill Wednesday. It goes next to the Senate Judiciary Committee.

“I’ve always thought this was a choice I wanted for myself,” said West and South Maui Sen. Rosalyn Baker, committee chairwoman. “I’ve seen too many of my friends with advanced stages in cancer waste away when they really wanted to be able to have that final control. I think choice in all areas is very, very important.”

The bill has wide support in the Senate, Baker said. The odds of it passing the House are about 50-50, said Scott Saiki, majority leader in the chamber.

The measure would apply to people with a confirmed prognosis of six or fewer months to live. The bill was modeled after a law in Oregon. To get the prescription, a patient would have to make an oral and written request.

Five states — California, Colorado, Oregon, Vermont and Washington — have laws to allow physician-assisted suicide, according to the National Conference of State Legislatures.

Opponents say people don’t have a choice about being born, so they shouldn’t have a choice about ending their lives. They also say ill patients may feel pressured to end their lives rather than be a burden to family members.

Cancer survivor Jack James said he was undergoing around-the-clock chemotherapy, in constant pain and had lost 96 pounds in about a month when doctors told him they didn’t think he would make it through the night.

“I fought for life,” James said. “I don’t want this bill to put the flame of a life in people like me potentially out.”

In the emotional and sometimes philosophical hearing, many bill supporters shared stories about watching parents or loved ones drop to weights as low as 45 pounds or unsuccessfully attempt suicide while waiting for the inevitable.

Nurse Malakai Grange talked about treating a 25-year-old dying from AIDS who had unsuccessfully tried to end his own life.

“His dignity and his autonomy had been totally lost,” Grange said. “He was dying in bed, no control over his bodily functions. He had a few people who were helping him as well as hospice. However, his condition had progressed to the point where there was no relief.”

In other testimony, the Department of the Attorney General submitted written comments recommending numerous amendments to the bill.

Among those changes would be allowing the measure to be applied to terminally ill nonresidents and providing immunity from prosecution for health care facilities.

The Department of Health took no position on the bill.

Kokua Mau, Hawaii Hospice and Palliative Care Organization took a position of “studied neutrality” on the measure, maintaining that the issue of medical aid in dying requires more discussion and examination.

Kat West, director of policy and programs for Compassion & Choices, testified in favor of the bill on behalf of the nonprofit working to improve end-of-life care and choices for terminal patients.

“Many dying patients suffer, even with the best care and pain management,” she said. “Terminally ill people should have a full range of end-of-life options.”

Hawaii Family Forum President Eva Andrade testified against the measure, saying “suicide is contagious.”

“Physician-prescribed, lethal-dose ‘cocktails’ are not a medical treatment, and we should not promote that message to our keiki,” she said.

Walter Yoshimitsu, executive director of the Hawaii Catholic Conference, strongly opposed the bill, speaking as the public policy voice for the Roman Catholic Church.

The measure could blur long-standing medical, moral and legal distinctions between withdrawing medical assistance and taking active steps to destroy human life, he said. “One lets people die a natural death; the other is deliberate and direct act of hastening death.”

And, Yoshimitsu said, such a legal option “can lead to psychological, financial and other pressures for vulnerable persons to end their lives,” he said. “In today’s era of health care rationing and cost-cutting, assisted suicide could easily rise to the level of the most acceptable, and even expected ‘treatment’ for terminal illness.”

* The Maui News contributed to this report.